July Junior Athlete Workshop Registration Form 2026

Junior Athlete Workshop Registration Form

To be completed by Parent registering their child for July 10th GSAS Juniors.
Athlete/Child Name

First NameLast Name
Athlete Date of Birth

MonthDayYear
Date
Primary Contact/Gaurdian

NameRelation to Child
Parent/Guardian Primary Email
example@example.com
What sport/s does the athlete play?
e.g. basketball, tennis, swimming etc.
Athlete Gender
Which age group will the athlete be participating in?
Does the athlete have any medical conditions, disabilities, injuries or other factors that may impact their ability to participate safely in physical activities or require specific support during the program? If yes, please provide details below or contact us directly to discuss how we can accommodate their needs.
If yes, please provide all relevant information
Parent/Guardian Emergency Contacts
I, the undersigned, hereby give permission for my child to participate in the Junior Athlete Development program organized by the Great Southern Academy of Sport (GSAS).
The workshop will be held on a court at Albany Leisure & Aquatic Centre.

The cost of the workshop is $25 per athlete and includes ALAC entry.

Please transfer to GSAS prior to confirm your place. Your childs place is not confirmed until payment is received.

Great Southern Academy of Sport

BSB 633 000

ACC 152 531 125
Date

MonthDayYear
Date
Signature (Parent/Guardian)
Should be Empty: